MMWR Recomm Rep. 1996 Feb 16;45(RR-1 Suppl):1-20.
Streptococcus pneumoniae is a leading cause of morbidity and mortality in the United States, resulting each year in an estimated 3,000 cases of meningitis, 50,000 cases of bacteremia, 500,000 cases of pneumonia, and 7,000,000 cases of otitis media. As with most respiratory pathogens, rapid, sensitive, and specific diagnostic tests are not available; thus, early in the course of illness, diagnosis of S. pneumoniae infection is usually presumptive, and the choice of antimicrobial therapy is nearly always empiric. In the past, isolates of S. pneumoniae were uniformly susceptible to penicillin; however, penicillin-resistant and multidrug-resistant strains have begin to emerge in the United States and are widespread in some communities. The full impact of the problem is unknown because infection with drug-resistant S. pneumoniae (DRSP) is not a reportable condition for most of the United States. To develop a strategy for minimizing the impact of DRSP, in June 1994, CDC convened a working group of public health practitioners, clinical laboratorians, health-care providers, and representatives of key professional societies. This report describes the three goals developed by the working group that address surveillance, epidemiologic investigation, and prevention and control of DRSP, and the objectives for each goal.
肺炎链球菌是美国发病和死亡的主要原因，每年估计导致3000例脑膜炎、50000例菌血症、500000例肺炎和7000000例中耳炎。与大多数呼吸道病原体一样，目前尚无快速、灵敏且特异的诊断检测方法；因此，在疾病早期，肺炎链球菌感染的诊断通常是推测性的，抗菌治疗的选择几乎总是经验性的。过去，肺炎链球菌分离株对青霉素普遍敏感；然而，耐青霉素和多重耐药菌株已开始在美国出现，并在一些社区广泛传播。由于在美国大部分地区，耐药物肺炎链球菌（DRSP）感染并非须报告的疾病，所以该问题的全面影响尚不清楚。为制定一项将DRSP影响降至最低的策略，1994年6月，美国疾病控制与预防中心（CDC）召集了一个由公共卫生从业者、临床检验人员、医疗保健提供者以及主要专业协会代表组成的工作组。本报告描述了该工作组制定的三个目标，这些目标涉及DRSP的监测、流行病学调查以及预防和控制，还阐述了每个目标的具体目的。
